Fifth Disease (Erythema Infectiosum)
- Erythema Infectiosum (Fifth Disease) is usually a mild infection which is caused by human parvovirus (B19). It is characterized by a facial rash (“slapped cheek” appearance) and a lacelike rash on the trunk and the extremities. Reddening of the skin may fade and recur due to nonspecific stimuli such as temperature or sunlight. Low-grade fever and mild systemic symptoms may be seen. In patients with certain red blood cell abnormalities (such as sickle cell disease and auto-immune hemolytic anemia), parvovirus B19 infection can cause an aplastic crisis. Infection with the virus can also result in chronic anemia in some immunodeficient persons. Infection during pregnancy carries some risk of fetal death.
- Infection is most common in school-aged children. Epidemics of the illness can occur in schools, typically in late winter and spring. Approximately 50 percent of adults have serologic evidence of past infection, in contrast to 5-10 percent of preschool aged children.
- From 4-14 days, but can be as long as 20 days.
PERIOD OF COMMUNICABILITY:
- People with Fifth Disease appear to be contagious during the week prior to the appearance of the rash. By the time the rash appears, they are probably no longer infectious.
- Transmission is through droplet contact and close person to person contact.
- Although Fifth Disease is usually a mild, self-limited illness, 3 groups of persons are at risk for serious complications of infection: 1) person with chronic hemolytic anemia, 2) persons with congenital or acquired immunodefieciencies, and 3) pregnant women. The school nurse should inform those people in the high risk categories when Fifth Disease is present in the school.
- It is felt that people who have been previously infected probably acquire long-term or lifelong immunity.
CONTROL OF SPREAD:
- No measures are available to control the spread. During an outbreak, those people in the risk groups should consult their physician for advice.
- There is no specific treatment.
- This is difficult because the greatest risk of transmitting the virus occurs before symptoms develop.